2005, 03-02 Permit App:05000607 Remodel-� o
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FF__ REQUIRED SITE INFORMATION
Street Address: G114_25' 1-41A
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: —1,`" /"
Building Permit ❑ Change in Use ❑ Grading
Relocation ❑ Tenant Improvement ❑ Fire Safety
OWNER/APPLICANT INFORMATION
❑ Owner:L�
Phone: Fax:
Address:
city
❑ Contractor:
Phone:
Address
City
State Zip Code
Fax:
State Zip Code
❑ Manufactured Home
❑ Other
❑ Applicant: SGi 17-e
Phone: Fax:
Address:
city
❑ Architect:
Phone: _
Address
C ity
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
State Zip Code
Fax:
State Zip Code
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
AIN FLOOR TO SQ. FTG:
M
2 FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
NISHED BASEMENT SQ. FTG:
%JC U
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
ER R 00 SITE SEPTIC
SYSTEM? O
I MANUFACTURED HOME I
Width: Length: Year: Pit Set:
Manufacturer:
Previous Address:
Proposed Use: _
RELOCATION
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time: _
Valuation: Above/Underground Storage Tank Size:
I WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE I
Plans Examiner.
Address:
Inspector:
Address:
Phone:
Fax:
City, State Zip
Phone: ,Fax:
City State Zip
I " SPECIAL INSPECTIONS I
❑ BOLTING
Firm Name:
Inspector(s):
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in fult compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name
Signature
Method of Payment: (Faxed permit. applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #:
Authorized Signature:
Expires: _ VIN#:
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EMERGENCY EGRESS REWREMENTS
FROM SLEEPMIG ROOMS
1) NET CLEAR OPENING: 5.1 SQUARE FEET
GRADE FLOOR OPENING (MAX 44') 5.0 SQUARE FEET
2) NET CLEAR OPENING HEIGHT 24 INCHES
3) NET CLEAR OPENING IMDTH 2O INCHES
4) MAX FINISHED SILL HEIGHT 44' ABOVE FLOOR
5) EMERGENCY ESCAPE & RESCUE OPENING SHALL BE
OPERATIONAL_ FROM THE NMSIOE OF THE ROOM IMTHOUT _rhr